Active NPI
Richard Jeffrey Antwi-Boasiako, DPT
- Physical Therapist
- Dallas, TX
National Provider Identifier
1760765192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1201659
- Practice address
- 1450 Empire Central Dr
Ste 100
Dallas, TX 75247-4027 - Phone
- (866) 425-5768
- NPI assigned
- Sep 22, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1201659 | TX | Primary |
| Physical Therapist | 225100000X | P12927 | NC |
Addresses
Primary practice location
1450 Empire Central Dr
Ste 100
Dallas, TX 75247-4027
Mailing address
2772 Sweetbriar Lane
Brampton, ONTARIO L6P1P8
CA
Phone (905) 793-6788
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P12927 | NC | MD | Physical Therapist |
| 1201659 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1760765192",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "2772 SWEETBRIAR LANE",
"city": "BRAMPTON",
"state": "ONTARIO",
"postal_code": "L6P1P8",
"telephone_number": "905-793-6788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 EMPIRE CENTRAL DR",
"address_2": "STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752474027",
"telephone_number": "866-425-5768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTWI-BOASIAKO",
"first_name": "RICHARD",
"middle_name": "JEFFREY",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1201659",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P12927",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.